'I Do Not Exist': Pathologies of Self Among Western Buddhists

This paper presents a clinical case involving a patient suffering 'depersonalisation' who had a psychotic episode at a Buddhist retreat. Recent writing on possible psychological risks of meditation has discussed problems of depersonalisation associated with misunderstandings of the Buddhist conception of non-self (anātman) and emptiness (śūnyatā). Drawing on the work of Winnicott and Bion, this article helps us to realise some of what is at stake in the failure to achieve and maintain an effective sense of self. What does Buddhist talk of non-self really mean? What conditions enable a creatively engaged and meaningful relational life, a sense of aliveness, human flourishing and a capacity for alterity?